Gastrosurgery UK

Gastrosurgery UK is founded and led by Mr Abhay Chopada. It is a team of dedicated professionals with a commitment to provide “Competent Compassionate Care” for all your embarrassing bowel problems and surgical conditions.

Mr Abhay Chopada MS FRCS

Gastrosurgery UK is led by Mr Abhay Chopada Consultant Laparoscopic, General and Colorectal Surgeon. He has been recognized by Tatler Magazine in their 2007 and 2013 Doctor's Guides as one of the Top Surgical Gastroenterologists in UK

Gall Bladder Surgery

The gallbladderis a pear-shaped sac that hangs like a little pod from a tree branch. This pod and its branch, the cystic duct, are attached to the common hepatic duct, which comes from the liver. These ducts lead into the common bile duct, which is attached to the duodenum, the entry to the small intestine. All the ducts from the liver and the gallbladder itself form the biliary system, often called the biliary tree.

Laparoscopic Colorectal Surgery

Laparoscopic colorectal surgery is a technique, which involves operations on the colon and rectum through 4 or 5 small incisions. A laparoscope (a narrow tube having a tiny camera) is inserted through the incision which gives the surgeon, an enlarged image of the internal organs on a television screen.

Upper GI Endoscopy

Endoscopy is a test which allows the doctor to examine the inside of the patient’s oesophagus, stomach, and portions of the intestine, with an instrument called an endoscope, a thin flexible lighted tube.It is performed by a well-trained subspecialist who uses the endoscope to diagnose and, in some cases, treat problems of the upper digestive system.By adjusting the various controls on the endoscope, the doctor can safely guide the instrument to carefully examine the inside lining of the upper digestive system.

FAQ's

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Management of Rectal Bleeding

Rectal bleeding is bleeding through the anus. The bleeding may be bright red, dark maroon or a tarry colour, which you may notice in your stools, toilet bowl or toilet paper.Rectal bleeding may occur from any part of the gastrointestinal …

In The News

Chronic bowel inflammation is diagnosed too late in children, adolescents

Cramping abdominal pains, diarrhea, bloody stools—these are common symptoms of chronic inflammatory bowel disease. Every year, thousands of children and adolescents develop the disease. But chronic inflammatory bowel disease is mostly diagnosed too late in these patients, experts suggests. The average delay between initial symptoms and diagnosis is four to six months. In most cases, the inflammation will by then have spread further.

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Post Operative Care

Most anorectal surgical procedures are done in same-day surgery. a few more extensive procedures require hospitalization for one to three days. You ability to tolerate the pain postoperatively and your doctor’s concern about your wounds determine the time of discharge.

In The News

Idiopathic pancreatitis is often caused by small gallstones that are difficult to observe prior to surgery, shows a study. Small gallstones were found in surgery from two out of three idiopathic pancreatitis patients. The study also showed that acute pancreatitis was more common in statin users than non-users

Patients hospitalized for gallstone-associated acute pancreatitis were less likely to be readmitted within 30 days if they underwent same-admission cholecystectomy, according to a nationwide retrospective analysis presented at ACG 2016.

Many people have gallstones without realizing it, as they rarely cause symptoms. But if people experience biliary colic, they may need surgery to remove the stones. Diet may play a part in creating gallstones, and eating a more healthful diet could prevent them forming.

This type of hernia is also sometimes called a lateral ventral hernia. Unlike most hernias, spigelian hernias do not typically develop below layers of fat but rather between muscles and the fascia — tissue that connects them.

QOL, other outcomes up with laparoscopic sx in diverticulitis
Source:Medicalxpress

The researchers found that for gastrointestinal symptoms or general QOL, there were no head-to-head comparisons between elective surgical versus conservative treatment of recurrent diverticulitis. Patients had higher QOL scores after elective laparoscopic resection than conservative treatment based on Short-Form 36 scores (73.4 versus 58.1, respectively). In all cohorts and in one trial comparing treatments, the proportion of patients with gastrointestinal symptoms was lower after laparoscopic surgery than conservative treatment (9 versus 36 percent; odds ratio, 0.35).

The Onstep technique for inguinal hernia repair is associated with a lower incidence of postoperative pain during sexual activity than the Lichtenstein surgical technique, according to a paper published online in Surgery.

Gall stones are one of the major causes of morbidity and mortality all over the world. Differences in primary outcomes like mortality and complication proportions (particularly bile duct injuries) are important reasons to choose one of the two operative techniques open or laproscopic Cholecystectomy.

Lower levels of vitamin D in the blood increase the risk of clinical relapse in patients with Ulcerative Colitis (UC), an inflammatory bowel disease that causes long-lasting inflammation and ulcers in the colon, a new study has found.

Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair.

Patient-derived organoids may help personalize the treatment of gastrointestinal cancers
Source:Sciencedaily

Organoids -- artificially grown masses of cells or tissues that resemble organs -- are being used by researchers in a range of biomedical fields as they study various disease states and work to develop potential treatments. Organoid culture methods have been established for healthy and diseased tissues from esophagus, stomach, intestine, pancreas, bile duct, and liver.

A strangulated hernia occurs when the blood supply to the herniated tissue has been cut off. This strangulated tissue can release toxins and infection into the bloodstream, which could lead to sepsis or death. Strangulated hernias are medical emergencies.

Following a strict gluten-free diet is important for anyone who has celiac disease, even if the disorder does not trigger any symptoms. Eating gluten when you have celiac disease injures the small intestine. Over time, that injury raises the risk for developing complications related to celiac disease.

When you’re experiencing discomfort in your groin, it can be concerning and at times, even embarrassing. It’s the reason so many men fail to seek out necessary preventive care and sometimes even urgent care.

Gallstones — the medical term is cholelithiasis — are solid collections of bile that can form in your gallbladder. The gallbladder is a small pear-shaped organ in your upper right abdomen below your liver. Your liver produces bile, which aids in fat digestion, and your gallbladder stores it.

Individuals with severe overweight have an inhibited sense of satiation - they release fewer satiety hormones than people of normal weight. The reason: the responsible cells in the gastrointestinal tract of obese people are severely reduced. This report Swiss doctors in the journal Scientific Reports. Surgical weight-loss procedures can repair this disorder.

Injections of onabotulinumtoxinA prior to hernia surgery relaxed the abdominal muscles and increased abdominal wall length by an average of 8 cm, based on data from an observational study of 56 patients.

The University of Luxembourg today announced the publication of a research article in the internationally renowned scientific journal Nature Communications. The article is based on research on the interaction between microorganisms in the gut and the human body through the development of the artificial 'HuMiX' model.

Researchers find link between hormones and inguinal hernias in older men
Source:News Medical

Researchers have identified an apparent cause of inguinal hernia, or groin hernia, in older men: altered sex hormone levels that weaken and scar muscle tissue in the lower abdomen. Results of their study using an animal model will be presented Monday at ENDO 2017, the Endocrine Society's 99th annual meeting in Orlando, Fla.

A treatment that blasts away gallstones that have found their way into the hard-to-reach bile duct is bringing relief to patients in pain – while sparing them major surgery that requires a week in hospital.

The treatment uses an electric current that creates shockwaves to shatter the stones in minutes, with no incisions required.

Investigators at the National Institutes of Health (NIH) and international colleagues have discovered a genetic cause and potential treatment strategy for a rare immune disorder called CHAPLE disease. Children with the condition can experience severe gastrointestinal distress and deep vein blood clots. No effective treatments are available to ameliorate or prevent these life-threatening symptoms.

Researchers at Wake Forest Institute for Regenerative Medicine have reached important milestones in their quest to engineer replacement tissue in the lab to treat digestive system conditions - from infants born with too-short bowels to adults with inflammatory bowel disease, colon cancer, or fecal incontinence.

Parastomal hernias are common in colorectal surgery; more than a quarter of ileostomy stomas and well over half of colostomy stomas herniate within 10 years of placement, leading to pain, leakage, appliance problems, and embarrassment for patients. There’s also the risk of bowel obstruction and strangulation.

QOL, other outcomes up with laparoscopic sx in diverticulitis
Source:Medical Xpress

(HealthDay)—For patients with uncomplicated diverticulitis, quality of life (QOL) and other patient-reported outcomes (PROs) are improved following laparoscopic surgery versus conservative treatment, according to a review published in the February issue of Clinical Gastroenterology and Hepatology.

The Onstep technique for inguinal hernia repair is associated with a lower incidence of postoperative pain during sexual activity than the Lichtenstein surgical technique, according to a paper published online in Surgery.

A new study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) has found that lower levels of vitamin D in the blood increase the risk of clinical relapse in patients with Ulcerative Colitis (UC), an inflammatory bowel disease that causes long-lasting inflammation and ulcers in the colon. The study was published in the journal Clinical Gastroenterology and Hepatology.

The intestine has a reservoir of stem cells that are resistant to chemotherapy
Source:Medical News Today

In healthy conditions, these cells have no apparent relevant function. However, they are important in situations of stress, , for example, after chemotherapy, in inflammatory processes, and in tissue infections - all conditions in which the population of "normal/active" stem cells is depleted.

Ascites, liver disease, diabetes, obesity, and primary suture repair without mesh are associated with increased umbilical hernia recurrence rates. Elective umbilical hernia repair with mesh should be considered in patients with multiple comorbidities given that the use of mesh offers protection from recurrence without major morbidity.

Idiopathic pancreatitis is often caused by small gallstones that are difficult to observe prior to surgery, shows a study from the University of Eastern Finland. Small gallstones were found in surgery from two out of three idiopathic pancreatitis patients. The study also showed that acute pancreatitis was more common in statin users than non-users.

Researchers from the University of Sheffield discovered a significant association between a patient’s vitamin D levels and the severity of their IBS symptoms, particularly the extent to which IBS affects their quality of life.

It is now well established that our health depends on the interaction between gut bacteria and the immune system. It has been suggested that the rich diversity of bacteria in our gut is the result of the two systems co-evolving and working on each other. Now, a new study provides evidence for one side of the theory – that the immune system influences the evolution of gut bacteria.

Microorganisms in the womb set stage for diseases
Source:Medical Xpress

Researchers review importance of microorganisms that exist in the gut, suggesting perturbation of the environment during pregnancy, delivery and early infancy could impact the developing baby’s early microbiome and set the stage for health problems later in life. The term “microbiome” refers to the trillions of organisms we harbor, on our skin and within our respiratory and gastrointestinal tracts.

The new year is nearly upon us, bringing with it resolutions to be healthier, happier and wiser in 2016. Undoubtedly, many of us are vowing to exercise more this year, and a new study suggests our gut flora – along with our trimmer waistlines – confers health benefits as a result of physical activity.

Irritable bowel syndrome, the most common gastroenterological disorder in the US, can now be diagnosed with just two simple blood tests, enabling early diagnosis for millions of people affected by the disorder.

In a small study in Chile that included patients with gallbladder cancer, exposure to aflatoxin (a toxin produced by mold) was associated with an increased risk of gallbladder cancer, according to a study in the May 26 issue of JAMA.

There was a 20 percent lower risk of cancers of the gastrointestinal tract, especially in the colon and rectum, among people taking aspirin, said lead researcher Yin Cao, a postdoctoral research fellow at the Harvard School of Public Health in Boston.

Ryan Ka Lok Lee, from the Prince of Wales Hospital in Hong Kong, and colleagues retrospectively evaluated 172 groin ultrasound results from 151 patients (101 men; mean age, 59 years). The accuracy of ultrasound in diagnosing the presence and type of groin hernia was determined as was any change in the accuracy of ultrasound over time (January 2002 through December 2010 [54 groins] versus January 2011 through December 2012 [118 groins]).

Cramping abdominal pains, diarrhea, bloody stools—these are common symptoms of chronic inflammatory bowel disease. Every year, thousands of children and adolescents develop the disease. But chronic inflammatory bowel disease is mostly diagnosed too late in these patients, experts suggests. The average delay between initial symptoms and diagnosis is four to six months. In most cases, the inflammation will by then have spread further.

How Can I Prevent Gallstones?
A sensible diet is the best way to prevent gallstones. Avoid crash diets or a very low intake of calories (less than 800 calories daily). Seek out good sources of fiber — raw fruits and vegetables, cooked dried beans and peas, whole-grain cereals and bran, for example — and avoid eating too much fat. A high-fiber, low-fat diet helps keep bile cholesterol in liquid form. However, don’t cut out fats abruptly or eliminate them altogether, as too little fat can also result in gallstone formation.

After gallbladder surgery, digestion can be tricky for a while – here’s what to avoid. When you have a problem with your gallbladder, like gallstones, your doctor may recommend that you have gallbladder surgery to remove your gall bladder.

Gallbladder removal is one of the most common operations performed in older adults. Yet, research from the University of Texas Medical Branch at Galveston shows many patients who would benefit most from the surgery don’t get it.

Clinical trial patients with metastatic colorectal cancer who had high levels of vitamin D in their bloodstream prior to treatment with chemotherapy and targeted drugs, survived longer, on average, than patients with lower levels of the vitamin, researchers report.

EnteroTrack, LLC and the University of Colorado (CU) have executed an exclusive license agreement that will allow the company to develop and market a novel device to monitor inflammation of the gastrointestinal tract.

Diagnosing inflammatory conditions of the gastrointestinal tract such as eosinophilic esophagitis (EoE), severe gastroesophageal reflux (GERD), eosinophilic gastroenteritis (EGE), food allergic enteropathy (FAE), and inflammatory bowel disease (lBD) is often difficult, since blood tests and radio-imaging aren’t able to pinpoint the cause of inflammation. Ultimately, many patients must undergo endoscopy – use of an instrument to visualize the esophagus and collect samples for testing.

There are many variables that contribute to a patient’s risk of chronic pain after surgery; physicians are still exploring ways to identify those variables prior to surgery. A study published in the Online First edition of Anesthesiology, the official medical journal of the American Society of Anesthesiologists® (ASA®), gives physicians a new planning tool to help identify patients’ risks of chronic pain after surgery.

The current classification system for colorectal cancer, which is based on genetic expression profiles, cannot be used to predict drug responses to the chemotherapy regimen called FOLFIRI. This is the conclusion reached by a team from the Spanish National Cancer Research Centre (CNIO), formed by members from the Gastrointestinal Cancer Clinical Research Unit and the Structural Computational Biology Group. The study, published in the journal Nature Medicine, will assist oncologists in making better-informed decisions regarding how to treat their colorectal cancer patients in the clinic.

New use for an old drug could impact cirrhosis patients
Source:Science Daily

A common drug used to clean a person’s bowels before a colonoscopy could become the future standard of care for patients with acute hepatic encephalopathy (HE), a mental disorientation problem that affects up to one in two cirrhosis patients. The finding comes from new research, known as the “HELP Clinical Trial,” that appeared in JAMA Internal Medicine on Sept. 22.

Researchers have identified why some people with celiac disease show an immune response after eating oats. The researchers have identified the key components in oats that trigger an immune response in some people with celiac disease. The findings may lead to better tests for oat toxicity, and have implications for new treatments being developed for celiac disease.

Past research has suggested that weight may be influenced by genes. A new study builds on this concept, revealing that our genetic makeup shapes what type of bacteria live in the gut, which may affect how heavy we are.

The findings come from a twin study conducted by researchers from Cornell University in Ithaca, NY, and King’s College London in the UK.

“Heartburn, we know, responds well to PPIs, but much less is known about treatment response with regurgitation,” Peter J. Kahrilas, MD, department of medicine, Northwestern University, said in a presentation. “In fact, no controlled trial has previously used regurgitation response as a primary outcome.”

IBS and bloating: When gut microbiota gets out of balance
Source:ScienceDaily

Irritable bowel syndrome belongs to the most widespread diseases in Western countries, causing up to 60 percent of the workload of gastrointestinal physicians. One of the most frequent symptoms of irritable bowel syndrome is bloating, which reduces quality of life considerably as patients perceive it as particularly bothersome. For quite a long time, irritable bowel syndrome was believed to be a primarily psychological condition.

An important new study funded by the Crohn’s& Colitis Foundation of America (CCFA) and published in the March 12 issue of Cell Host & Microbe, reveals several important findings that identify the microbiome in early-onset Crohn’s disease and highlight particular microbes that are increased or decreased in abundance in the disease.

TransoralIncisionless Fundoplication (TIF) is a safe and effective therapeutic option for carefully selected patients with chronic gastro-oesophageal reflux disease, according to the results of a registry published in the journal Surgical Laparoscopy Endoscopy and Percutaneous Techniques.

Data from the registry show that those quality-of-life scores remained the same or slightly improved over time, suggesting durability of outcomes between six- and 12-month follow-up. There were no major complications reported and oesophageal acid exposure was normalised in 14/27 (52%) of patients who underwent 12-month pH testing.

An innovative laparoscopic procedure that implants a ring of magnetic beads to help prevent acid reflux in patients who suffer from Gastroesophageal Reflux Disease (GERD) is the latest tool surgeons have to treat the disease. Using a small, flexible band of titanium beads with magnetic cores, surgeons implant the band around the patient’s esophagus just above the stomach. The magnetic attraction between the beads strengthens the weakened esophageal sphincter’s barrier function.

A healthy and balanced diet, as well as probiotics, has been known to be helpful in preserving gastrointestinal health for quite a long time. But it is only recently that the underlying mechanisms have become somewhat clearer.

Effective use of ultrasound for suspected appendicitis in children
Source:MedicalNewsToday

Using portable ultrasound as a first-line imaging study in kids with suspected appendicitis helps reduce emergency room length of stay and reduces the need for CT scans, according to a team of Mount Sinai researchers.

Using surgical mesh with suturing to repair abdominal hernias can reduce recurrence rates in comparison with suturing (rows of stitching) alone, but it increases other surgical risks, according to a review of studies by Mylan T. Nguyen, M.S., of The University of Texas Health Science Center at Houston, and colleagues.

More than 350,000 abdominal hernia repair surgeries occur in the United States annually, of which 75 percent are primary ventral hernias (weakening of the abdominal walls, usually at the navel). Despite the frequency of this surgery, there is insufficient evidence to support the use of sutures alone vs. sutures and mesh for primary ventral hernia repairs, according to the study background.

While the causes of Crohn’s disease are not well understood, recent research indicates an important role for an abnormal immune response to the microbes that live in the gut. In the largest study of its kind, researchers have now identified specific bacteria that are abnormally increased or decreased when Crohn’s disease develops.

For two years, Milagros Camacho struggled with what she thought was heartburn after every meal. At night stomach acid would sometimes come out of her mouth and nose. Even drinking water would set off her symptoms.

"I was afraid to eat," recalled Camacho, 55. Eventually she was diagnosed with gastroesophageal reflux disease, or GERD. It’s a chronic condition that can eventually lead to cancer of the esophagus.

Now scientists from the Florida campus of The Scripps Research Institute (TSRI) have identified a normally small subset of immune cells that may play a major role in the development of Crohn’s disease generally and in disease-associated steroid resistance specifically.

Lymphotoxin is a cytokine, or intercellular messenger, and plays an important role in the immunological balance of the gastrointestinal tract. It regulates the immune system of the digestive tract, which is made up of immune cells, immunoglobulins (antibodies) as well as intestinal bacteria. An international team of scientists supported by the Helmholtz Zentrum München has now discovered how this complex interaction functions and how lymphotoxin controls the production of immunoglobulins in the gut. The results are published in the latest issue of the specialist journal Science.

"Potentially avoidable hospitalizations are common in patients with advanced GI cancer," the authors write. "The majority of potentially avoidable hospitalizations occurred in patients with advanced treatment-refractory cancers near the end of life."

Scientists have more reasons for you to eat fiber and not abuse antibiotics.

They’ve shown that a receptor doctors already activate with mega-doses of niacin to protect patients’ cardiovascular systems also plays a key role in preventing colon inflammation and cancer, according to a study featured on the cover of the journal Immunity.

People with diets that promote inflammation—such as those high in sugar and saturated fats—are at increased risk for early death from all causes, including gastrointestinal tract cancers, a new study suggests.

Gastrointestinal tract cancers include cancers of the esophagus, stomach, colon and rectum

The types of bacteria in your gut today may be different tomorrow, depending on what kinds of food you eat, a new study suggests.

In the study, participants who switched from their normal diet to eating only animal products, including meat, cheese and eggs, saw their gut bacteria change rapidly within one day.

While the participants were on the animal-based diet, there was an increase within their guts in the types of bacteria that can tolerate bile (a fluid produced by the liver that helps break down fat), and a decrease in bacteria called Firmicutes, which break down plant carbohydrates.

A team including researchers from Rensselaer Polytechnic Institute has discovered that a specific gene may play a major role in the development of a life-threatening birth defect called congenital diaphragmatic hernia, or CDH, which affects approximately one out of every 3,000 live births.

Insomnia is associated with an increased risk for gastroesophageal reflux disease (GERD), findings from a cross-sectional study show.
Sleep apnea syndrome, however, was not associated with GERD, despite this being the focus of most studies assessing the relationship between
GERD and sleep disturbances to date.

The findings therefore highlight the need for sleep disturbances other than sleep apnea syndrome to be evaluated and correctly managed in patients with GERD, says the research team, led by In-Young Yoon (Seoul National University Bundang Hospital, Seongnam, Republic of Korea).